Carotid Artery Disease

Carotid artery disease (also called cerebrovascular disease) affects the vessels leading to the brain. Like the heart, the brain's cells need a constant supply of oxygen-rich blood. This blood supply is delivered to the brain by the 2 large carotid arteries in the front of your neck and by 2 smaller vertebral arteries at the back of your neck. The right and left vertebral arteries come together at the base of the brain to form what is called the basilar artery. A stroke may occur when the carotid arteries become blocked and the brain does not get enough oxygen.

Carotid artery disease increases the risk of stroke in 3 ways:

• By fatty deposits called plaque severely narrowing the carotid arteries.
• By a blood clot becoming wedged in a carotid artery already narrowed by plaque.
• By plaque or a clot breaking off from the carotid arteries and blocking a smaller artery in the brain (a cerebral artery).

Carotid endarterectomy is a type of surgery used to remove plaque from the carotid artery. It is the third most common kind of cardiovascular surgery in the United States.  During the operation, the surgeon peels the plaque away from the carotid artery. Once the plaque is removed from the carotid artery, more oxygen-rich blood can flow through the artery to the brain. This reduces the risk of stroke.

A transient ischemic attack (TIA) or "mini stroke." TIAs are episodes of dizziness, tingling, numbness, blurred vision, confusion, or paralysis that can last anywhere from a few minutes to a couple of hours.

A stroke marked by loss of vision, persistent weakness, or paralysis. That last longer than 1 week.

Carotid endarterectomy can prevent a future stroke and help relieve the symptoms of TIAs. Studies have shown that a carotid endarterectomy works better than medicines alone in preventing a stroke in people with severe blockages in the carotid arteries.

The Surgery

In 2005, the Journal Stroke published a review and meta-analysis of nine nonrandomized studies which showed that the use of local anesthetic was associated with significant reductions in the odds of death, stroke, stroke or death, myocardial infarction, and pulmonary complications, within 30 days of the operation.

Houston Cardiac Surgery Associates performs the Carotid endarterectomy under local anesthesia instead of general anesthesia. Thus our surgeons are better able to access brain function at all times during surgery.  The surgery takes about 1 to 2 hours, and you can expect to stay in the hospital overnight.

If you think you might be a candidate for “Carotid Endarterectomy” contact our office for an appointment. If you are considering having your heart surgery at St. Luke’s, Methodist, or Memorial Hermann, please contact us.